Territorial Health Insurance Fund

We offer paid prosthodontic services at our clinic, however, a new prosthodontic service provision and compensation procedure was approved on 1 October 2009, based on which residents that belong to certain categories can receive prosthodontic services free of charge or receive compensation for prosthodontic costs.

Residents eligible for compensation under this programme:

individuals who are of retirement age;

children under the age of 18 (prosthodontic services are available to children under 18 immediately and they do not have to be placed on the general waiting list; the scope and costs of prosthodontic work that such children require are typically greater than for other individuals)

individuals who have been recognised as unable to work or partially unable to work.

At present, compensation ranges from EUR 372.74 to 1,146.90. Compensation size depends on the condition of the patient’s teeth and their age (children under 18 typically receive greater compensation). The cost of prosthodontic services can be lower, but not higher than the upper limit of compensation. If the scope of prosthodontic services necessary exceeds the compensation sum, the patient can contribute to paying for the services themselves.

Documents necessary for receiving compensation:

1. Personal identification
2. A referral from a dentist (form 027/a). The patient must provide a referral from a dentist at the primary out-patient healthcare institution (POPHI) they are registered to. They can also get a referral from a dentist working at any other healthcare institution, however, this will probably mean that the patient will have to pay for the consultation appointment.
3. A document proving eligibility for compensation (disability or pensioner’s certificate).
4. A request to be placed on the waiting list for prosthodontic services.

These documents should be presented to the family clinic the patient is registered to (these documents can also be submitted by an authorised representative if, for example, the applicant is of old age and has difficulty walking). The clinic to which the patient is registered is responsible for submitting these documents to the Health Insurance Fund.

Later, the Health Insurance Fund will send the patient a letter by post to verify that they have been included in the waiting list for compensated prosthodontic services (i.e., that they are now waiting in line).

Once they have received such a notification from the Territorial Health Insurance Fund, the patient does not necessarily need to wait for their turn to come or an invitation – they can pay for the prosthodontic services themselves. If they wish to receive compensation for these services, the patient will have to submit the following documents to the Territorial Health Insurance Fund:

a request in the approved form (a request for compensation for services rendered that needs to indicate the bank account No. to which the sum of compensation can be transferred);

the original copy of the invoice that indicates the sum to be compensated from the budget of the CHIF (Compulsory Health Insurance Fund);

a notification about the patient’s inclusion on the waiting list for compensated prosthodontic services (if you have not saved your notification, a THIF employee will issue a duplicate).

Or you can wait for a second letter, i.e., the written invitation to begin the prosthodontic process. In this second case, the patient will not have to pay for the prosthodontic services because the Health Insurance Fund will directly compensate the clinic that carried out the prosthodontic work, if the clinic has signed a contract with the Territorial Health Insurance Fund (as our clinic has).